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Diffuse interstitial lung disease: overlaps and uncertainties

Diffuse interstitial lung disease: overlaps and uncertainties Histopathological analysis of lung biopsy material allows the diagnosis of idiopathic interstitial pneumonias; however, the strength of this diagnosis is sometimes subverted by interobserver variation and sampling. The American Thoracic Society and European Respiratory Society recommendations of 2002 provide a framework for the diagnosis of interstitial lung disease (ILD) and proposed an integrated clinical, radiological and histopathological approach. These recommendations represent a break with tradition by replacing the ‘gold standard’ of histopathology with the combined ‘silver standards’ of clinical, imaging and histopathological information. One of the pitfalls of a rigid classification system for the diagnosis of interstitial lung disease is its failure to accommodate the phenomenon of overlapping disease patterns. This article reviews the various ways that interstitial lung disease may be classified and discusses their applicability. In addition the issue of overlap disease patterns is considered in the context of histopathological interobserver variation and sampling error and how a pigeonhole approach to disease classification may overlook these hybrid entities. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Radiology Springer Journals

Diffuse interstitial lung disease: overlaps and uncertainties

Walsh, Simon; Hansell, David
European Radiology , Volume 20 (8) – Mar 4, 2010
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References (51)

Publisher
Springer Journals
Copyright
Copyright © 2010 by European Society of Radiology
Subject
Medicine & Public Health; Internal Medicine ; Ultrasound; Neuroradiology ; Imaging / Radiology; Interventional Radiology ; Diagnostic Radiology
ISSN
0938-7994
eISSN
1432-1084
DOI
10.1007/s00330-010-1737-3
pmid
20204644
Publisher site
See Article on Publisher Site

Abstract

Histopathological analysis of lung biopsy material allows the diagnosis of idiopathic interstitial pneumonias; however, the strength of this diagnosis is sometimes subverted by interobserver variation and sampling. The American Thoracic Society and European Respiratory Society recommendations of 2002 provide a framework for the diagnosis of interstitial lung disease (ILD) and proposed an integrated clinical, radiological and histopathological approach. These recommendations represent a break with tradition by replacing the ‘gold standard’ of histopathology with the combined ‘silver standards’ of clinical, imaging and histopathological information. One of the pitfalls of a rigid classification system for the diagnosis of interstitial lung disease is its failure to accommodate the phenomenon of overlapping disease patterns. This article reviews the various ways that interstitial lung disease may be classified and discusses their applicability. In addition the issue of overlap disease patterns is considered in the context of histopathological interobserver variation and sampling error and how a pigeonhole approach to disease classification may overlook these hybrid entities.

Journal

European Radiology – Springer Journals

Published: Mar 4, 2010

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